Is it sensory, behaviour, or communication?

Tantrums are never much fun at the best of times. They present even more challenges when children with autism are living under ‘stay at home’ orders.

What do you do to manage tantrums?

The answer to this can be very confusing for parents. When you speak to an Occupational Therapist, they may tell you that the tantrum is due to a sensory issue. The Occupational Therapy solution might be to do some sensory integration therapy. When you speak to the Psychologist, they might tell you that it’s behavioural issue. The psychology solution could be to start a behavioural program. When you speak to a Speech Pathologist, they will tell you that the tantrum is a result of a communication difficulty. The Speech Pathology solution is very likely to be a recommendation to work on the child’s communication.

So, who is correct? They are all correct explanations for the cause of the tantrum because tantrums initially start because of sensory, behavioural, or communication issues.

Let’s look at an example. Luke is 4 years old and drives with his Mum to swimming lessons every Monday afternoon. Recently, he has started to have a tantrum in his car seat when they turn into the street where the swimming pool is. Mum can’t work out the reason for the tantrum, but it happens every week. She starts to consider all the options:

• Luke doesn’t like a lot of noise. The indoor swimming pool where he has his lesson is very noisy, and an extra lesson that has been added at the same time as Luke’s lesson. That means the noise level in the swimming pool is much higher. He has the tantrum because he gets overwhelmed by the sensory experience in the pool.
• Three weeks ago, they stopped at the petrol station on the way to swimming lessons. Mum filled up the car with petrol and bought Luke a packet of his favourite chips. He hadn’t eaten much that day and she didn’t want him to be hungry in the swimming lesson. Mum thinks he might want a packet of chips every time they drive to swimming lessons now, but Luke is non-verbal. He has the tantrum because he can’t tell her that he wants a packet of chips.
• Mum thinks that Luke doesn’t really enjoy the swimming lesson. She wonders if he has a tantrum when they drive into the street where the pool is because he doesn’t want to do the lesson. The tantrum is his way of avoiding the swimming lesson.

All of these sound like perfectly reasonable explanations. The tantrum could be because of a sensory, behavioural, or communication issue. However, if they persist, they become behavioural issues regardless of the initial cause.

What do you do about tantrums?

Children have tantrums for two main reasons:

1. They want something they can’t get at the time
2. They want to avoid something that is happening or about to happen

In Luke’s case, he might want the chips, or he might to avoid the noise of the swimming pool or the actual lesson itself.

If a child is having a tantrum because of a sensory issue or a communication issue, you can’t solve these concerns in the middle of a tantrum. They are long term issues that need to be supported through therapy. The most effective thing to do in the middle of the tantrum is to use behavioural principles so that it stops. What the adult or carer does during the tantrum determines whether the tantrum continues, escalates, or happens again. If you give Luke the chips because you worked out that that was what he wanted, you have taught him that tantrums are an effective form of communication. If you leave the pool because of the noise or because you realised Luke really doesn’t like the lesson, you have taught him that tantrums are a really good was of getting out of things he doesn’t like.

When behavioural principles are used correctly during a tantrum, the child learns that the tantrum doesn’t work. The tantrum doesn’t get them the chips, the tantrum doesn’t stop the noise in the swimming pool, and the swimming lesson goes ahead despite the tantrum. When behavioural principles are used correctly during a tantrum, the child is less likely to use them in the future. It takes consistence and persistence to manage tantrums. If they are managed well, they will reduce.

What’s the difference between a tantrum and a meltdown?

‍A meltdown is a tantrum that escalates. In a meltdown, the child is totally overwhelmed by not being able to manage what is happening around them. It isn’t specific to a sensory or communication issue. It can happen for many reasons. Often, something else has tipped the child over before the event that sets off the meltdown.

Luke’s Mum used behavioural strategies to manage the tantrum in the car on the way to the pool. She also worked with a psychologist to teach Luke new behaviours to use when he gets upset. She worked with the Speech Pathologist and Occupational Therapist to improve Luke’s communication when he is overwhelmed by noise. The car rides to the swimming pool are back to normal – tantrum free!

If you are concerned about your child’s tantrums, talk to your therapists, and ask about the behavioural strategies that can be used to manage the tantrum.

Written by Susan Marden

Speech Pathologist

Director – OneOnOne Children’s Therapy